How Depo-Provera Works. Depo-Provera's active ingredient is depot-medroxyprogesterone acetate (DMPA), a synthetic form of the natural hormone progesterone, originally developed for the treatment of uterine cancer in the 1950s. The woman receives 150 milligrams of DMPA via deep intramuscular injection every three months.
       Depo-Provera was approved for use in the United States in October 1992. In June of 1993, however, Canada's Department of Heath and Welfare prohibited the use of Depo-Provera, saying that the drug did not meet Canadian safety standards as a contraceptive.[60] Depo-Provera is now available in more than 90 countries and is particularly popular among population controllers in Indonesia, Jamaica, Thailand, Kenya and New Zealand.
       As with all other abortifacients that may pose a danger to Western women, Depo-Provera was extensively tested on Third World women first. The World Health Organization (WHO) used Depo on more than 11,000 women in Kenya, Mexico and Thailand before submitting it to the FDA for approval.[61]
       According to Upjohn's information pamphlet on Depo-Provera, the compound "inhibits the secretion of gonadotropins which, in turn, prevents follicular maturation and ovulation and results in endometrial thinning. These actions produce its contraceptive effect."[62] The pamphlet also says that Depo-Provera:

• "[Has a] contraceptive effect produced by inhibiting the secretion of gonadotropins (FSH, LH), which prevents follicular maturation and ovulation.
• Suppresses the endometrium [the mucous membrane lining the uterus] and changes cervical mucus."

       In other words, Upjohn acknowledges that Depo-Provera acts as an abortifacient.
       Many women's menstrual cycles continue when using Depo-Provera: 43 percent after 12 months and 32 percent after 24 months.[63] This data shows that the compound does not completely suppress ovulation in a large percentage of women who use Depo-Provera.
       Contraceptive Technology confirms that Depo-Provera has a three-way mode of action. It inhibits ovulation and thickens cervical mucus (which are both contraceptive actions), but it also alters the endometrium (the lining of the uterus) so that its degree of receptivity to the blastocyst (very early developing human being) is significantly decreased. According to Contraceptive Technology, "Other contraceptive actions include the development of a shallow and atrophic [thinning] endometrium ..."
       When Depo-Provera works in this way, it is an abortifacient.[64]

       Adverse Reactions to Depo-Provera. Upjohn's information pamphlet on Depo-Provera lists more than 60 adverse reactions suffered by women who use the compound.[65]
       Women on Depo-Provera report an average weight gain of 5.4 pounds in the first year and 16.5 pounds over six years. Depo-Provera users commonly experience osteoporosis (loss of bone mass).[66] Some users also suffer jaundice, a decrease in glucose tolerance and convulsions.
       In women who have used Depo-Provera for the first time within the last four years, and who are under 35 years of age, the risk of breast cancer increases 129 percent.[67] No increased risk of ovarian, liver or cervical cancer is apparently associated with the drug's use.
       Use of Depo-Provera may be associated with ectopic pregnancy, thrombophlebitis (inflammation of blood vessels associated with blood clots), pulmonary embolism (obstruction of the pulmonary artery by a blood clot, air bubble, or other material), cerebrovascular disorders, and partial or complete loss of vision in mothers, and polysyndactyly (webbing and extra digits of the hands and feet), hypospadias (genital tract abnormalities) and chromosomal anomalies among infants born to them.[68]
       More than five percent suffer headaches, nervousness, abdominal pain or discomfort, dizziness or asthenia (weakness or fatigue). One to five percent reported one or more of these ailments: Decreased libido (sexual desire) or anorgasmia, depression, nausea, insomnia, leukorrhea (abnormal vaginal discharges), pelvic and breast pain, rashes, hot flashes, edema (swelling), vaginitis and acne.[69]
       The information pamphlet lists 48 other symptoms reported by lesser numbers of patients, including chest pains, pulmonary embolus, allergic reactions, anemia, tachycardia (racing heart rate), fever, hoarseness, blood dyscrasia (abnormal blood chemistry), rectal bleeding, breast lumps or nipple bleeding, paralysis, facial palsy, uterine hyperplasia (abnormal growth of the uterus), varicose veins and deep vein thrombosis.[70]

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Footnotes for "(3) Depo-Provera"

[60] HLI Newswire, June 3, 1993.

[61] HLI Newswire, June 19, 1992.

[62] Patient information brochure. "Now Available in the U.S.: Depo-Provera Contraceptive Injection." Upjohn Pharmaceutical Company, December 1992.

[63] Ibid.

[64] Robert Hatcher, M.D., M.P.H. Chapter 20, "Depo-Provera Injections, Implants, and Progestin-Only Pills (Minipills)." Robert A. Hatcher, et. al. Contraceptive Technology (18th Revised Edition) [New York: Ardent Media, Inc.], 2004, pages 461 to 494.

[65] Patient information brochure. "Now Available in the U.S.: Depo-Provera Contraceptive Injection." Upjohn Pharmaceutical Company, December 1992.

[66] On October 30, 1992, the Los Angeles Times, Houston Chronicle, and Minneapolis Star-Tribune, among other major newspapers, reported that "Use of Depo-Provera may be considered among the risk factors for developing osteoporosis. The rate of bone loss is greatest in the early years of use. ... A slight increased overall risk of breast cancer has been associated with use in women under 35 years of age whose first exposure to the Depo-Provera Contraceptive Injection was within the previous four years. Other complications include weight changes, menstrual irregularities, headache, dizziness, nervouisness, abdominal pain or discomfort, and asthenia (weakness or fatigue)."

[67] Ibid.

[68] Patient information brochure. "Now Available in the U.S.: Depo-Provera Contraceptive Injection." Upjohn Pharmaceutical Company, December 1992.

[69] Ibid.

[70] Ibid.